Cochlear implant extrusion in a child with keratitis, ichthyosis and deafness syndrome

We present a child with keratitis, ichthyosis and deafness (KID) syndrome implanted with a Nucleus device. We discuss the would complications of this child and the steps taken to deal with the problems encountered when the wound failed to heal, followed by the partial extrusion of her implant. Early surgical management involved resuturing the wound but when this failed a rotational flap was required to cover the implant package and allow eventual healing. Despite the wound problems and revision surgery she has a good audiological result.

Delayed extrusion of a cochlear implant: a case report of an implant extruding 21 months after the original operation

We present a case report of a lady who received a Nucleus 22 Channel cochlear implant in July, 1992. She presented again in April, 1994 when the cochlear implant had extruded spontaneously. The possible aetiology of this extrusion, as well as the technique of surgical management, is discussed.

Electrode placements for cochlear implants: a review

Of the variety of different sites that have been proposed and used for cochlear implants, only two are now seeing widespread use. For single-channel electrodes, it appears that a placement at the round window, or just inside it, leads to no disadvantages (and perhaps some advantages) over deeper insertions. For multichannel implants, it appears that intra-cochlear electrodes are, generally speaking, preferable to extra-cochlear ones in a variety of ways, especially as the early fears about the dangers of intra-cochlear placement now seem exaggerated. One way in which extra-cochlear approaches may play an important accessory role in multichannel intra-cochlear implants is in allowing access to the apical end of the cochlea where residual nerve survival is likely to be best. Special considerations may apply for groups of patients who until recently have been implanted relatively infrequently--adults with significant residual hearing and children.

Medical or surgical complications related to the Nucleus multichannel cochlear implant

A questionnaire was sent to 152 surgeons to survey complications associated with the implantation of the Nucleus multichannel cochlear implant. Complications were categorized as life-threatening; major, if they necessitated revision surgery; or minor, if they resolved spontaneously or with minimal treatment. A total of 55 complications occurred in 459 reported operations for an overall complication rate of 11.8%. There were no deaths, but there was one life-threatening complication, a case of meningitis. There were 23 (4.8%) major complications, most of which involved flap design or electrode insertion (and included the case of meningitis). There were 32 (7%) minor complications. Most of the complications might have been avoided by proper training, planning of the operations, and careful attention to detail. We recommend that all prospective implant surgeons attend a device-specific training course and practice in the temporal bone laboratory.